Carcinom spinocelualar terebrant apărut pe lichen plan hipertrofic

Abstract

Introduction: Lichen planus is a benign papulo-squamous dermatosis with a muco-cutaneous involving that affects 1-2% of population. Neoplastic transformation of lichen planus lesions occurs very rarely, being described especially in oral lesions. Malignant transformation of cutaneous lichen planus lesions, although very rare, has been described in isolated cases of chronic hypertrophic lichen planus localized on lower limbs. Clinical case: We present the case of 49 years old female patient, diagnosed with lichen planus with onset in adolescence, which was consulted for a deep ulceration localized on the internal aspect of the right calf, with onset of about a year that led to observe the underlying muscle and tendon structures. No inguinal lymphadenopathies were found. Erythemato-violaceous, itchy, plane papules and residual hyperpigmented macules were noted on the wrists and forearms, and large brown pruritic papules on the dorsal side of the feet and the internal aspects of the calves were observed. Oral and genital mucosas were normal. Histopathological examination of skin biopsy sample taken from the superior edge of ulceration shows a moderately differentiated squamous cell carcinoma. Due to the large size of the tumour surgical excision was not possible opting for amputation on the middle third of the right thigh. Discussion: This case is presented in order to emphasize the possibility of squamous cell carcinoma arising from a lichen planus skin lesion, especially when it comes to the persistent lesion, nonresponsive to treatment. This type of lesions should be suspected of malignancy transformation requiring a biopsy to rule out a possible squamous cell carcinoma.